Although we do not know much about Miguel and Sandra’s relationship, it is very likely that Miguel’s abuse has not been limited to the occasional physical assault. O’Leary (1999) writes that psychological abuse, which can include threats, ridicule, and the destruction of property (p. 13), “generally precedes physical aggression” (p. 19).
The affects of domestic violence (DV), both physical and psychological, can be devastating, with women often claiming that psychological abuse has the most negative impact on them (O’Leary, 1999, p. 13). Campbell (2002) writes that DV victims have higher rates of depression, anxiety, insomnia, social dysfunction, and substance abuse (pp. 1333-1334). One study found post-traumatic stress disorder (PTSD) in 45 percent of abused women, while another study found it in 81 percent of women who had been physically abused and 63 percent who had been verbally abused (Barnett, 2002, p. 11).
The devastating effects of DV might at least partially explain why Sandra has not left Miguel. Barnett (2001) writes that many abused women stay with their spouses because “their problem-solving abilities have diminished” (p. 12) due to such factors as “excessive stress,” postconcussion syndrome, and “cognitive distortions associated with PTSD” (Barnett, 2001, pp. 11-12). It is also possible that Sandra has not left because she fears retaliation (Barnett, 2001, p. 10) or lacks the economic wherewithal (Barnett, 2000, p. 347). Another reason might be that she is socially isolated. Agoff, Herrera, and Castro, (2007) write that social connections often provide individuals with more “direct support,” as well as increased “feelings of competency and personal efficacy” (p. 1206).
There is perhaps nothing that Sandra could do to stop Miguel’s abuse. Jacobson, Gottman, Gortner, Berns, and Shortt (1996) found “no wife behaviors that influenced the longitudinal course of violence in the marriages that remained intact” and therefore concluded that perhaps “the only reliable pathway that women have for cessation of violence is to leave the relationship” (p. 389).
Miguel’s abuse will probably have a negative impact on their children. Kolbo, Blakely, and Engleman (1996) found that “children who witness domestic violence are at risk for maladaptation in one or more of the following domains of functioning: (a) behavioral, (b) emotional, (c) social, (d) cognitive, and (3) physical” (p. 282). Miguel was himself likely affected by the abuse he suffered as a child, as it predisposed him to being abusive in later intimate partner relationships (Heise, 1998, p. 267).
Latino Culture
Men and women in Latino culture are traditionally placed into distinct and rigid roles. The man is considered “the head of the family, the sole provider, the protector, and the authority figure” (Perilla, 1999, p. 114). He is “thought to be superior” (McGhee, 1997, p. 137), and young boys learn that a man has “absolute power and control” over his wife and children and that they are his “possessions,” obligated to “attend to his needs and expectations” (Perilla, p. 120).
The Latino woman is traditionally considered “the person in charge of child rearing and of the well-being of her family” (Perilla, 1999, p. 114). At a young age girls learn that “marriage is of utmost importance and essential to their identity” (Perilla, p. 122). The average girl learns to derive her “sense of identity and self-esteem” from performing such tasks as “putting other’s needs before her own; standing by and supporting her husband, regardless of his behavior; being a good mother; and keeping the family together” (Perilla, p. 123).
DV is often tolerated in Latino culture. Many Latinas learn early in life that “domestic abuse is an expected—even necessary—part of marriage/relationships” (Perilla, 1999, p. 123). Glantz, Halperin, and Hunt (1998) found in their study of women in Chiapas, Mexico, that Latinas often blame DV victims, assuming “that the woman is being punished for some transgression of her assigned role” (p. 390).
Given all this, Latinas who suffer DV are generally reluctant to reach out to others for help. Marrs Fuchsel, Murphy, and Dufresne (2012) found in their study of Mexican immigrants that all DV victims “at some point wanted to reach out to family members” but “were afraid and embarrassed because of what the family might say” (p. 267).
Latinas who experience DV consequently “find themselves torn” between “obligations to themselves” and cultural and internal pressures to “to preserve and maintain the family” (Edelson, Hokoda, and Ramos-Lira, 2007, p. 8). Given this conflict, the decision “to leave an abuser, although extremely difficult for all women, may be intensified for Latina women” (Edelson, Hokoda, and Ramos-Lira, p. 8). This intensification, Edelson, Hokoda, and Ramos-Lira posit, explains why Latinas who experience DV have “significantly poorer outcomes on measures related to trauma, depression, self-esteem, and attributional style” (pp. 7-8).
Problem Areas and Strengths
Sandra’s problem areas are evident. First, she is committed to an abusive man, one who terrifies her so greatly that in his presence she becomes “weak and ineffectual.” Second, she appears to be socially isolated. Her sister is evidently her closet ally, but she lives in Colorado Springs, at least an hour’s drive from Sandra’s home in Denver. Third, Sandra’s children “all have [severe] learning and behavior problems.”
Sandra also has several strengths. First, she is a “bright, well-organized and capable woman” who speaks English “perfectly.” Second, she is resilient. Despite the severity of Miguel’s abuse, she has managed continue functioning fairly normally. Third, she has a strong sense of loyalty and has probably covered up for her husband in the past lest she hurt her children and family.
My Role as Social Worker
As a social worker, I am mandated to report Sandra’s injuries to the local police (Family Violence Prevention Fund, 2010, p. 15). In addition to reporting her injuries to the police, I would, first, try to strike up a rapport with her (Kirst-Ashman and Hull, 2012, p. 36), something that is especially important with Latino clients (Seipel, 2006). I would next try to obtain all the relevant information needed to make an assessment (Kirst-Ashman and Hull, p. 37) and would then work with her to make a plan (Kirst-Ashman and Hull, p. 40).
I would also share certain information with Sandra. I would make her aware of the law and her rights, emphasizing that informing the authorities of Miguel’s abuse would not result in her losing her children (Perilla, 1999, p. 125). I would also inform her of the available forms of help, including safe houses, support groups, and counseling services for herself, her husband, and her children. I would encourage her to join a support group. There she could learn that she is not alone and receive the encouragement needed to forge a new, less self-destructive, identity (Perilla, Serrata, Weinberg, and Lippy, 2012, p. 101). She could also receive encouragement to “become aware of the need to carefully examine cultural codes and values, leaving aside those that have the potential for violence and destruction” (Perilla, Serrata, Weinberg, and Lippy, p. 101).
Ethical Problem
It is possible that the hospital staff workers were simply venting their frustrations. It is also possible that they truly believe what they said and avoid helping battered Latinas. Whatever the case, they were clearly speaking about a patient in a derogatory manner, which violates the NASW Code of Ethics (National Association of Social Workers, 2008, 1.12). If they in fact avoid helping battered Latinas, then they are committing discrimination, another NASW violation (National Association of Social Workers, 4.02). They have also violated my personal values, specifically my belief that those in power are obligated to help the vulnerable without discrimination.
I consider this situation to be an ethical problem, not an ethical dilemma, as it has “a clear solution” (Kirst-Ashman and Hull, 2012, p. 416). As stipulated in the NASW Code of Ethics, my “primary responsibility is to promote the well-being of clients” (National Association of Social Workers, 2008, 1.01). Since these staff workers might be hurting clients by refusing to treat them, I am obligated to “take adequate measures to discourage, prevent, expose, and correct” their “unethical conduct” (National Association of Social Workers, 2.11a). I am also obligated to stop their behavior based on the Dolgoff, Loewenberg, and Harrington “Ethical Principles Screen,” as the right of Latinas to receive “fair and equal treatment” takes precedence over any right these workers have to deny such treatment because they personally believe it is “a waste of time and taxpayer money” (Kirst-Ashman and Hull, 2012, p. 416).
I should address their unethical behavior, first of all, by directly discussing my concerns with them, provided, that is, that I believe the conversation “is likely to be productive” (National Association of Social Workers, 2008, 2.11c). If this course of action does not work, then I am obligated to take action through appropriate formal channels” (National Association of Social Workers, 2.11d).
References
Agoff, C., Herrera, C., and Castro, R. (2007). The weakness of family ties and their perpetuating effects on gender violence: A qualitative study in Mexico. Violence Against Women, 13(11), 1206-1220.
Barnett, O.W. (2000). Why battered women do not leave, part 1: External inhibiting factors within society. Trauma, Violence, & Abuse, 1(4), 343-372.
Barnett, O.W. (2001). Why battered women do not leave, part 2: External inhibiting factors—social support and internal inhibiting factors. Trauma, Violence, & Abuse, 2(1), 3-35.
Campbell, J.C. (2002). Health consequences of intimate partner violence. The Lancet, 359.
Edelson, M.G., Hokoda, A., and Ramos-Lira, L. (2007). Differences in effects of domestic violence between Latina and non-Latina women. Journal of Family Violence, 22(1), 1-10.
Family Violence Prevention Fund. (2010). Compendium of state statutes and policies on domestic violence and health care. Retrieved from http://www.acf.hhs.gov/sites/default/files/fysb/state_compendium.pdf
Glantz, N.M., Halperin, D.C. , and Hunt, L.M. (1998). Studying domestic violence in Chiapas, Mexico. Qualitative Health Research, 8(3), 377-392.
Heise, L.L. (1998). Violence against women: An integrated, ecological framework. Violence Against Women, 4(3), 262-290.
Jacobson, N.S., Gottman, J.M., Gortner, E., Berns, S., and Shortt, J.W. (1996). Psychological factors in the longitudinal course of battering: When do couples split up? When does the abuse decrease? Violence and Victims, 11(4), 371-392.
Kirst-Ashman, K.K. and Hull, G.H. (2012). Understanding generalist practice (6th ed.). Belmont, CA: Brooks/Cole.
Kolbo, J.R., Blakely, E.H., and Engleman, D. (1996). Children who witness domestic violence: A review of empirical literature. Journal of Interpersonal Violence, 11(2), 281-293.
Marrs Fuchsel, C.L., Murphy, S.B., and Dufresne, R. (2012). Domestic violence, culture, and relationships dynamics among immigrant Mexican women. Affilia: Journal of Women and Social Work, 27(3), 263-274.
McGhee, M.P. (1997). Cultural values and domestic violence. Journal of Family Social Work, 2(2), 129-140.
National Association of Social Workers. (2008). Code of ethics of the National Association of Social Workers. Retrieved from
O’Leary, K.D. (1999). Psychological abuse: A variable deserving critical attention in domestic violence. Violence and Victims, 14(1), 3-23.
Perilla, J.L. (1999). Domestic violence as a human rights issue: The case of immigrant Latinos. Hispanic Journal of Behavioral Sciences, 21(2), 107-133.
Perilla, J.L., Serrata, J.V., Weinberg, J., and Lippy, C.A. (2012). Integrating women’s voices and theory: A comprehensive domestic violence intervention for Latinas. Women and Therapy, 35(1-2), 93-105.
Seipel, A. (Fall 2006). Culturally competent social work practice with Latino clients. The New Social Worker. Retrieved from
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